NUR 312 Exam 1
heart failure risk factors?
*hypertension obesity hyperlipidemia coronary artery disease family history
Which of the following examples should be provided as food to include with dietary intake when taking furosemide (Lasix)?
.Potatoes, milk, and prune juice Furosemide is a diuretic that will decrease potassium levels. A diet high in potassium is needed to replace potassium that is lost. Cauliflower, cabbage, and yogurt are high in vitamin K. Macaroni and cheese, deli meat, and buttermilk are high in sodium. Clams, oysters, and broccoli are high in calcium. Potatoes, milk, and prune juice have high potassium levels
what is the intermediate insulin onset?
1-2 hrs
what is the #1 thing to cause hypergylcemia?
1.obestiy - health 2. medications - corticosteriods 3. infetion 4. stress
Hypertension is diagnosed when the client demonstrates a systolic blood pressure greater than ______ mm Hg or a diastolic blood pressure greater than _____ mm Hg over a sustained period
130, 80
how can a doctor diagnosis hypertension?
3 BP check in a week
what is the Short acting insulin onset?
30 minutes to 1 hour - give 20 to 30 mins before meals
how can you assess for JVD?
45 degree angle
most deaths occur at what age?
65 and older
What is hospice care?
A type of care given to patients with PROGNOSIS OF LESSS THAN 6 MONTHS to live that focuses on alleviating physical symptoms (NOT CURING) & addressing psychological, social, and spiritual concerns (of the patient's family as well).
medications for hypertension (ABCDD)
A- ACE inhibitors - pril "chill pril for the heart) ARBS - lowers BP "losartan, chill man" B-Beta Blockers- lol "blocks beats" C- calcium channel blockers "calms hearts, control BP) D- Diuretics - k+ wasting and sparing Dilators - nitroglycerine
side effects for ACE inhibitors (LisinoPRIL)
A- Angioedema (swollen lounge) C- cough E- electrolyte imbalances (hyponatremia, hyperkalemia)
what surgerys are for PVD and PAD?
A- angioplasty (balloon or stents) B- bypass "CABG" C- cut out the fatty blockage. (endarterectomy)
medications for PVD and PAD?
A- antiplatelet (caution: bleeding) C- cholesterol lowering lovastatin (caution: liver toxic, NO grape juice)
The registered nurse is reviewing information with coronary staff nurses about the renin-angiotensin-aldosterone system (RAAS). Which statement made by an attending nurse indicates understanding
A. "RAAS is a mechanism that regulates arterial blood pressure.
what is some s/s we migh see in patients with hypertension?
ABCs achy head blurred vision. chest pain
what medication is the first line of defense for HTN and HF?
ACE
medications for patients who are non African or 60 or less?
ACE-1 or ARB
what is the difference between arteriosclerosis and atherosclerosis?
ARTeriosclerosis effects the small arteries and ATHerosclerosis effects the intima of large and medium sized arteries.
what is pulmonary edema?
Abnormal accumulation of fluid in the alveoli (where gas exchange occurs) and interstitial spaces of the lungs.
what is cellulitis?
An acute, spreading infection of dermal and subcutaneous tissues
what is the most common manifestation of atherosclerosis?
Angina Pectoris
what are priority assessments for perfusion?
BP/HR/Pulse urine output skin color/temp
Why is atherosclerosis dangerous?
Because the heart muscle receives less blood and oxygen from narrowing of coronary vessels and may lead to a heart attack from
An older adult woman's current medication regimen includes alendronate. What outcome would indicate successful therapy?
Bisphosphonates such as alendronate increase bone mass and decrease bone loss by inhibiting osteoclast function. These drugs do not treat infection, pain, or tumors.
how does DKA start?
Blood sugar level go up but insulin is not going into the cell. body thinks its in a state of hypoglycemia so liver releases glycogon. blood sugar still isnt going down, so body breaks down fat for energy creating ketones
4 cautions for beta blockers
Bradycardia (60 or less) cant give. Bottomed out BP/ hypotension - hold medications. breathing problems (COPD, asthma) can't give. blood sugar masking - caution diabetics
what is the inflammatory marker for cardiovascular risk, including acute coronary events and stroke
C-reactive protein
what is the cardiac output equation?
CO = SV x HR
Which medication directly inhibits osteoclasts, thereby reducing bone loss and increasing bone mass density (BMD)?
Calcitonin directly inhibits osteoclasts, thereby reducing bone loss and increased BMD. Raloxifene reduces the risk of osteoporosis by preserving BMD without estrogenic effects on the uterus. Teriparatide has been recently approved by the FDA for the treatment of osteoporosis. Vitamin D increases the absorption of calcium.
A nurse is reviewing the pathophysiology that may underlie a client's decreased bone density. What hormone should the nurse identify as inhibiting bone resorption and promoting bone formation?
Calcitonin inhibits bone resorption and promotes bone formation, estrogen inhibits bone breakdown, and parathyroid increases bone resorption. Estrogen, which inhibits bone breakdown, decreases with aging. Parathyroid hormone (PTH) increases with aging, increasing bone turnover and resorption. Progesterone is the major naturally occurring human progestogen and plays a role in the female menstrual cycle.
what does a doppler ultrasound do?
Determines the degree of blood flow in peripheral arterial dx
treatments for hypertension (DRESS)
Diet - low SCC (sodium calories, cholesterol) Reduce alcohol and caffeine. Exercise by waking - 30 min x 5 a week. Stop smoking and drinking alcohol. Stress reduction
Gerontologic considerations for Angina
Diminished pain transition that occurs with aging may affect presentation of symptoms "Silent" CAD Teach older adults to recognize their "chest pain-like" symptoms (i.e., weakness) Pharmacologic stress testing; cardiac catheterization Medications should be used cautiously!
Which diagnostic study is usually performed to confirm the diagnosis of heart failure?
Echocardiogram
what are the two hyperglycemic emergency
HHS and DKA
A client with congestive heart failure is admitted to the hospital after reporting shortness of breath. How should the nurse position the client in order to decrease preload?
Head of the bed elevated 45 degrees and lower arms supported by pillows Preload refers to the degree of stretch of the ventricular cardiac muscle fibers at the end of diastole. The client is positioned or taught how to assume a position that facilitates breathing. The number of pillows may be increased, the head of the bed may be elevated, or the client may sit in a recliner. In these positions, the venous return to the heart (preload) is reduced, pulmonary congestion is alleviated, and pressure on the diaphragm is minimized. The lower arms are supported with pillows to eliminate the fatigue caused by the pull of the client's weight on the shoulder muscles.
he nurse also assesses the client's sensorium and LOC. Why is the assessment of the client's sensorium and LOC important in clients with heart failure?
Heart failure ultimately affects oxygen transportation to the brain.
what are the top 2 risk factors for coronary artery disease?
Hypertension and coronary artery disease
what is resistant hypertension?
Hypertension that is not responsive to at least 3 antihypertensive medications from different classes
what are symptoms of PVD?
Intermittent claudication, described as aching, cramping, inducing fatigue or weakness that occurs with some degree of exercise or activity
A nurse is assessing a client with congestive heart failure for jugular vein distension (JVD). Which observation is important to report to the physician?
JVD is assessed with the client sitting at a 45° angle. Jugular vein distention greater than 4 cm above the sternal angle is considered abnormal and is indicative of right ventricular failure.
which lipid has a strong assoiciation with advancing CAD?
LDL
discharge teaching for a client with venous insufficiency. Which information will the nurse include in the instructions?
Management of the client with venous insufficiency is directed at reducing venous stasis and preventing ulcerations. Discharge teaching should include increasing the time walking because sitting or standing in one position is detrimental. The foot of the bed should be elevated approximately 6 inches to help with venous return. The legs should be elevated for 15 to 20 minutes four times a day to reduce the development of swelling in the legs during the day. Socks that are tight at the top of the leg should not be worn as this can encourage edema and possibly skin breakdown. Graduated compression stockings should be removed during the night and applied in the morning when the amount of blood in the leg veins is at the lowest.
intermittent caudation is found in what?
PAD, pain - unrelieved at rest parathesis polar paralysis pallor
the health consequences of uncontrolled hypertension. What health problems should the nurse describe?
Potential complications of hypertension include the following: left ventricular hypertrophy; MI; heart failure; transient ischemic attacks; cerebrovascular disease; renal insufficiency and failure; and retinal hemorrhage. Venous insufficiency and right ventricular hypertrophy are not potential complications of uncontrolled hypertension.
Which is a manifestation of right-sided heart failure?
Right-sided heart failure causes systemic venous congestion and a reduction in forward flow. Left-sided heart failure causes an accumulation of blood in the lungs and a reduction in forward flow or cardiac output that results in inadequate arterial blood flow to the tissues. Some clients with left-sided heart failure get episodes of dyspnea at night, known as paroxysmal nocturnal dyspnea.
A client presents at a clinic reporting back pain that goes all the way down the back of the leg to the foot. The nurse should document the presence of what type of pain?
Sciatica nerve pain travels down the back of the thigh to the foot of the affected leg. Bursitis is inflammation of a fluid-filled sac in a joint. Radiculopathy is disease of a nerve root. Tendonitis is inflammation of muscle tendons.
What are statins used for?
Statins are used to lower the risk of heart and circulatory diseases.
The nurse caring for a client with a leg ulcer has finished assessing the client and is developing a problem list prior to writing a plan of care. What priority risk would the care plan address?
The client with leg ulcers is at risk for insufficient nutrition related to the increased need for nutrients that promote wound healing.
The nurse is administering furosemide to a client with heart failure. What best describes the therapeutic action of the medication?
The medication blocks sodium reabsorption in the ascending loop and dilate renal vessels.
or the treatment of hypertension. What potential therapeutic benefits of antihypertensives should the nurse identify?
The medications used for treating hypertension decrease peripheral resistance, blood volume, or the strength and rate of myocardial contraction. Antihypertensive medications do not increase venous return or decrease blood viscosity.
hypertensive medication with its side effect.
Thiazide diuretics may deplete potassium; many clients will need potassium supplementation. Direct vasodilators may cause headache and increased heart rate. Adrenergic inhibitors can cause sedation and fatigue. Beta-blockers may induce decreased heart rate; pulse rate should be assessed before administration. Angiotensin-converting enzyme inhibitors can induce a mild to severe dry cough.
Lipid profile values
Total cholesterol less than 200 mg/dL Triglycerides under 150 mg/dL LDL under 100 mg/dL HDL over 40 mg/dL for men. 50 mg/dL for women.
is DKA type 1 or type 2 ?
Type 1
What is orhtopnea?
Unable to breathe when laying down
The nurse is caring for a client who is admitted to the medical unit for the treatment of a venous ulcer in the area of the lateral malleolus that has been unresponsive to treatment. Which finding is the nurse most likely to identify during an assessment of this client's wound?
Venous ulcerations in the area of the medial or lateral malleolus (gaiter area) are typically large, superficial, and highly exudative. Venous hypertension causes extravasation of blood, which discolors the area of the wound bed. Bleeding is not normally present.
what is hyperhylcemia hyperosmolar syndrome? (type2)
a medical emergency absent ketones osmotic diuresis profound dehydration - from urinating taking fluid from vascular symptoms. electrolyte
as cells become less able to replace themselves they accumulate what?
a pigment known as lipofuscin
What is atherosclerosis?
abnormal accumulation of lipid deposits and fibrous tissue within arterial walls and the lumen
What is atherosclerosis?
accumulation of lipid, calcium, blood components, carbohydrates deposits on the walls of large arteries.
Are ketones acidic or basic?
acid, too much and then patients can go into metabolic acidosis
what is the most common type of hospitalization for older adults?
acute decompensated Heart failure
patient education for newly diagnosed hypertension includes what?
aerobic activity/ brisk walking alcoholic beverages in moderation sodium reduced to no more than 100 mmol/day. normal BMI between 18.5 and 24.9
what are non modifiable risk factors for heart failure?
age, race, family history, genetic, kidney conditions, congenital heart defects
changes in renal function are mainly due to what?
aging and hypertension causing decreased filtration rate, diminished tubular function.
What are Kussmaul respirations?
an effort to rid the body of increased CO2 levels and usually occur with hyperglycemia
age related changes in the hematopoietic system influence red blood cell production leading to increased rates of what?
anemia
how do you assess the vascular system?
ask health history, location of pain, if they have "rest pain." physical assessment of skin (cool, pale, dry, brittle nails) check pulses.
hypertension complications? AABC
atherosclerosis (scarred, hard arteries) aneurysms (bursting blood vessels) broken (kidneys, eyes and heart failure) clots (pulmonary emboli, stroke, MI)
what is the main cause of coronary artery disease?
atherosclerosis, buildup of fat deposits that harden over time.
what should you teach a patient with angina?
balance activity with rest avoid exercise in hot temps avoid OTC meds that increase HR or BP before consulting with Provider. stop using tobacco products diet low in fats and high in fibers
what is ACHS?
before meals and at bed time
what is hypoglycemia?
blood sugar less than 60 and symptomatic
what 3 things affect blood pressure?
blood volume, peripheral resistance and cardiac output
What is type one diabetes mellitus?
body does not produce insulin - heredity
*what is the hierarchy of a dying persons needs
bottom: biological and physiological integretity - pain, physical s/s safety & security: voice hidden fears
digoxin toxicity causes what?
bradycardia - hold if below 60 BPM blurry or yellow vision
what are abnormal findings related to HF?
bradycardia, tachycardia extra heart sounds tachypnea, confusion, bluish tinge skin or nails cold clammy skin, peripheral edema
how can we tell if a patient is retaining fluid?
by taking daily weights
medications for African Americans or older than 60 with hypertension?
calcium channel blockers or thiazide diuretic
what is a balanced meal for diabetes?
carbohydrates (45-60%) fats (less than 20%) proteins (15-20%)
what is a example of not a normal age related change?
cataracts, dementia, alzheimers
depression cause elevated what?
catecholamines, which is present in stressful states causing endothelial damage and inflammation to platelet activation.
what are potential causes of lower back pain?
cauda equina syndrome osteoarthritis of spine spinal stenosis acute lumbosacral strain obesity
need to know for Furosimide?
causes orthostatic hypotension - fall risk waste potassium - electrolyte imbalance
What is angina pectoris?
chest pain caused by inadequate flow of blood and oxygen to the heart
what are four modifiable risk factors for CAD?
cholesterol abnormalities, tobacco use, HTN, and diabetes
what is hyoergylcemic crisis signs and symptoms?
coma, seizures, diabetic ketoacidosis
What is a geriatric syndrome?
common conditions found in older adults such as fall, urinary incontinence, dizziness
prevent of coronary artery disease?
control cholesterol dietary manage HTN, diabetes, medications stop using tobacco
what are symtoms of left sided heart failure
crackles in the lung, pulmonary edema
pain from PAD is associated with what?
critical ischemia of the distal extremity, ischemic rest pain is usually worse at night
What is presbyopia?
decrease in visual accommodation that happens with old age
what are normal findings related to age?
decreased CO, HR, SV myocardial hypertrophy cellular ageing and fibrosis valvular rigidity
orthostatic and postprandial hypotension may be a concern because of what?
decreased baroreflex and sensitivity and risk factors such as medication
myocardial hypertrophy causes what changes?
decreased left ventricular strength, increased fibrosis and calcified tissues causing stenosis of valves and decreased pacemaker cells.
what happens to the kidneys during decreased cardiac output?
decreased urine output brown urine increased BUN and creatinie decreased GFR
what is venous thromboembolism?
deep vein thrombosis to pulmonary embolus.
as you age what happens to your skin?
dermis becomes thinner decreased elastic fibers collagen becomes stiffer subcutaneous fat diminishes decreased conserved heat
what diagnostic test do we use for PAD and PVD?
doppler ultrasound
how do you prevent thromboembolism?
early ambulation and leg exercise compression socks lifestyle changes subcutaneous heparin or LMWH
A client has been having cardiac symptoms for several months and is seeing a cardiologist for diagnostics to determine the cause. How will the client's ejection fraction be measured?
echocardiogram
what is the nursing care for cellulitis?
elevate affected area 3 to 6 inches above the heart. warm, moist packs to site every 2 to 4 hours. educate patients about prevention and foot/skin care.
what makes pain better for PVD
elevate legs
imaging for hypertension looks for what?
enlarged ventricle - left ventricle hypertrophy. using chest Xray, echocardiogram, ECG and EKG
since respiratory disease manifest more subtly in older adults what could be some symptoms?
fatigue, anorexia, dehydration, lethargy, mental status change
what is a concern of retaining too much fluid?
fluid can eventually go into the lungs causing pulmonary edema (airways effected)
what is pallative care?
for anytime during a illness to support the patient manages symptoms for quality of life extends beyond the hospital establish realistic goals - community resourrces + greif support
what should adults who need to lower LDL eat?
fruits, veggies, whole grain, beans nuts and seeds. minimal processed foods, minimal intake of red meat. limit intake of sweets and sugar drinks
what medications are given to diabetics
glipizide metformin insulin
what medication is not effective for type 1 diabetes?
glipizide metformin
patients on calcium channel blocker or statins cant have what?
grapefruit or grapefruit juice
what makes pain better for PAD?
hang legs over bed
what is ARTeriosclerosis
hardening of the arteries
What is the leading cause of death of older adults?
heart disease
if a patient has high blood pressure (HTN) they a likely to develop what?
heart failure
Symptoms of atherosclerosis
heart failure, heart attack (MI), pain in jaw or left arm, *ANGINA pectoris*
in simple terms what happens during myocardial hypertrophy
heart valves become stiffer and thicker, heart muscles and arteries lose their elasticity resulting in reduced stroke volume
what should you avoid with patients who have PVD or PAD?
hot temperatures (impaired feeling) foot trauma (impaired sensation) constriction (cross legs, tight clothing, caffeine, cold temperatures)
what is the result of diabetes?
hyperglycemia
if a patient has diabetes and taking corticosteriods what should you be aware of?
hyperhylcemia, additonal "coverage" insulin?
difference between hypertensive emergency and urgency
hypertensive emergency >180/120 and must lower bp to stop further organ damage vs hypertensive urgency is >180/20 but NO evidence of organ damage.
how should we treat patients with hypoglycemia?
if the patient is concious, give simple carb (juice, hard candy, sugar packets) AND a protein (peanut butter sandwhich) if the patient in unconcoious, give medication (glucagon; oral paste or dextrose; IV)
what is heart failure?
inability of heart to meet oxygen O2 demands of the tissue.
what is the goal for patients with peripheral vascular problems?
increase arterial blood supply. decrease venous congestion. vasodilation relief of pain
hypertension can result from?
increase in cardiac output, increase in peripheral resistance (constriction of blood vessels) or both.
what are NONmodifiable risk factors of atherosclerosis and PAD?
increasing age familial predisposition/genetics
digoxin has what type of contractility?
inotropic agent
which medications work for type 1 diabetes?
insulin
What is type two diabetes?
insuline resistance - sedetary lifestyle
what to expect to see with PAD?
intermittent cAudation - sharp cAlf pain cool to touch (no oxygen) thin scaley skin decreased hair. thick toenails necrotic tissue little drainage little granular tissue
Why is HDL good cholesterol?
it transports other lipoproteins such as LDL to the liver where they can be degraded and excreted which is why a high HDL is good
why is hypertension called the silent killer?
its usually asymtomatic
what are symtoms of right sided heart failure
jugular venous distention, portal HTN turns into ascities, peripheral edema
patients with PAD, which position should you keep them in?
keep lower extremities in a neutral or dependent position to enhance blood flow in contrast, patients with venous insufficiency blood return to the heart is needed so lower extremities are elevated.
a decreaed GFR indicates what?
kidney failure, and you will have increased BUN and creatinine
what happens during the dying phase?
lathargic period of alertness possible hallucinations or anger.
how do you manage hypertension?
lifestyle modification weight reduction decreased sodium. aerobic activity reduced alcohol.
what is the death rattle?
loud rattling sound when reathing in a person that is actively dying caused by secretions
patients with venous insufficiency should be in what position?
lower extremities elevated to promote blood return to the heart.
cellular aging and tissue deficits diminish the body's ability to do what?
maintain homeostasis and prevent organs from functioning at full efficiency
once a patient is concious after hypoglycemia should you leave them?
monitor patient, every 15-30 minutes
Atherosclerosis symptoms are caused by what?
myocardial ischemia
What is PAD (peripheral artery disease)
narrow arteries and can't bring blood to distal extremities (fingers and toes)
What is PVD (peripheral vascular disease)?
narrow veins and can't bring blood to heart.
what are signs and symptoms of cauda equina syndrome?
neurologic deficit bowel / bladder dysfunction paresthesia's in the perineal, inner thigh or butt
what are modifiable risk factors of atherosclerosis and PAD?
nicotine use diabetes hypertension hyperlipidemia diet stress sedentary lifestyle c-reactive protein hyperhomocysteinemia*
with PVD, ischemic rest pain is worse during what time of day?
night and often wakes patients up
what to expect during comfort care?
no vital signs no blood draws
is pallative care giving up on the patient?
no, its a change in focus. from curing the patient to quality of life
is the absence of chest pain in a older adult a reliable indicator of the absence of heart disease?
no, older adults present symptoms differently than younger patients
What are the CNS symptoms of hypoglycemia?
numbness to lips, headache, lighthheadness, confusion, memory lapse, seizres, coma, death
modifiable risk factors for heart failure?
obesity, hypertension, hyperlipidemia, smoking, sedentary lifestyle, medications, alcohol intake.
what are some heart failure sleep pattern changes?
obstructive sleep apnea
which medication should nitroglycerin patch not be used with?
other nitrates such as levitra
What is a durable power of attorney?
patient designates a surrogate to make medical decisions in event he/she loses decision making capacity
who can recommend pallative care?
patient, family, doctors,
pharmacologic therapy for PVD?
phosphodiesterase lll inhibitor - cilostazol antiplatelet agents - aspirin, clopidogrel statins
what patient education is needed for Nitroglycerin SL tablets
place under Tounge, allow to dissolve DO NOT swallow or chew. take no more than 3 tablets, 5 mins apart. keep in original glass container.
signs and symptoms of hypergylcemia?
polyuria,polydispia, altered mental status, dehydration
how do we improve peripheral arterial circulation?
positioning - body part below level of heart exercise: isometric exercises, walking temperature; effects of hot and cold discourage use of nicotine stress reduction
what happens to the ejection fraction duriing diastolic heart failure?
preserved ejection fraction
What is the goal of hypertension treatment?
prevent complications of organ damage and death by maintaining blood pressure lower than 130/80
what nutrients help with leg ulcers?
protein, vitamin c and A, iron and Zinc
what are cardiac catheters used for?
radiopaque cithers are inserted into a specific area of the heart and a contrast media injected to assess coronary artery patency and degree of atherosclerosis.
What happens to the ejection fraction in systolic heart failure?
reduced ejection fraction
what activities hel to maintain adequate respiratory function?
regular exercise, fluid intake, pneumococcal vaccine, yearly influenza and avoiding people who are ill
Which insulin ONLY can be given IV?
regular insulin ONLY none else
what is the cause of secondary hypertension
renal disease, sleep apnea, pregnancy related
how do you relieve symptoms of PVD?
rest
what are the nursing interventions for patients with leg ulcers?
restoring skin integrity - cleaning wound, avoid heat improving mobility - restricted physical activity, exercise upper extremities, promote blood flow, analgesics beofre schedules activites adequate nutrition - protien, vitamin c and A iron and zinc
what is a potential side effect of statins?
rhabdomyolysis, destruction of muscle cells
diastolic/systolic heart failure usually affects what side of the heart?
right - diasotlic left - systolic
what is heart failure?
right side affects diastolic left side effects systolic
what are normal age related changes?
sensitivity to glare, slight forgetfulness
if a patient is hypogylcemia and concious you give hem what?
simple carb and proteins (Ex. juice, peanut butter sandwhich)
Types of Angina
stable, unstable, variant
A client with a previous myocardial infarction and asymptomatic heart disease is categorized under which category?
stage B heart failure
what are some causes of hypertensions? (SODA)
stress obesity diet/diseases a- african americans
what is acute decompensated heart failure?
sudden increase in HF s/s, pulmonary congestion and fluid overload
SNS symptoms of hypoglycemia
sweating, tremors, tachycardia/palpations
What are the s/s of cellulitis?
swelling or redness, fever, chills and sweating treat with oral or IV antibiotics
what a s/s of hypoglycemia?
the brain wants blood sugars - not enough energy altered mental status, headaches
what is cauda equina syndrome?
the bundle of spinal nerves arise from the lower portion of the spinal cord, when the nerves become compressed pt will have s/s
What is ejection fraction?
the percentage of blood ejected from the heart during systole
what is the problem with left systolic heart failure?
there is a contraction problem
what is the problem with diastolic heart failure?
theres a filling issue
patients with uncomplicated hypertension and no specific indication for another medication, what is recommended?
thiazide diuretic is the recommended initial medication for most patients.
Potassium sparing diuretics does what?
treat CHF and hypertension. blocks sodium channels inhibits.
what is the cause of primary hypertension
unknown cause but most common
what type of angina is not relieved by rest?
unstable, requires medical intervention
which type of diet can reduce blood lipids, blood glucose, body mass and blood pressure?
vegetarian
aging produces changes in the walls of the blood vessels, what happens?
vessels stiffen affecting transportation of oxygen and nutrients to the tissues. impaired blood flow increased left ventricular workload. increased peripheral resistance.
what should you expect to see in PVD?
warm skin + pulses present - (due to oxygen) thick tough skin yellow brown/ purple ankles edema from pooling blood irregular sores no sharp pains (due to oxygen present)
what are signs and symptoms of diabetic ketoacidosis (DKA) - Type 1
weakness, fatiguem kussamal respirations, fruity breath
what is rapid insulin?
works in 15 minutes and BS starts - given before meals
do lifestyle practices have a large impact on skin changes?
yes
does the respiratory system compensate well for the functional change of aging?
yes
can diabtes be cured with exercise?
yes but if not medication will be needed.
after you administer medication to a patient who is hypoglycemic an unconcious
you wait with them until their concious, give them a simple carb and protein. once they are concious
what are nursing diagnosis for HF?
• Activity intolerance • Impaired gas exchange • Decreased cardiac output • Decreased cardiac tissue perfusion • Ineffective cerebral tissue perfusion • Ineffective peripheral tissue perfusion • Impaired social interactions • Anxiety/death anxiety • Defensive/ineffective coping
what are goals for HF?
• Health promotion • Control HTN, hyperlipidemia • Low Na+ diet • Annual vaccines • Maintain CO and oxygenation • Optimal symptom management • QOL maintenance/minimize ADRs • Identify & mitigate risks for ADHF • Monitor response to therapies • Patient education